ST段压低经心率校正后对冠心病的诊断价值

目的 评价平板运动试验中ST段压低经心率(HR)校正后对冠心病的诊断价值。方法 53例临床拟诊冠心病患者,先后行平板运动试验和冠状动脉造影(CAG)检查,根据结果分为冠心病(CHD)组和非CHD组,比较△ST/△HR指数和最大ST/HR斜率。结果 CHD组△ST/△HR指数、最大ST/HR斜率大于非CHD组(P<0.001),且3支病变者大于1～2支病变者(P<0.05);△ST/△HR指数法、最大ST/HR斜率法对冠心病诊断的敏感性高于ST段压低法(分别为90.3％、92.3％、80.6％,P<0.05),△ST/△HR指数法特异性高于ST段压低法(81.8％vs72.7％,P<0.05)。结论 ST段压低法经心率校正后可提高平板运动试验对冠心病诊断的敏感性和特异性,优于单纯ST段压低法。     

老年糖尿病患者无症状心肌缺血与微量白蛋白尿的关系

目的探讨老年糖尿病患者无症状心肌缺血与微量白蛋白尿的关系,以利于冠心病的早期预防和治疗。方法将存在微量白蛋白尿的老年糖尿病患者42例作为研究组,另选年龄,性别、糖尿病病程与之相匹配的无微量白蛋白尿症的老年糖尿病患者40例做为对照组,采用次极量的踏车运动试验,记录心肌缺血的发生率,运动时间,最大运动量,高峰心率。结果研究组与对照组比较,心肌缺血反应的发生率较高(64%vs43%,P<0.05),平均运动时间较短[(6.7±2.2)vs(8.1±2.1)min,P<0.01),最大运动心率亦较低(113±18次/min vs 125±16次/min,P<0.01),运动量较低[640±215kg/(m·min)vs 738±213kg/(m·min),P<0.01]。结论存在微量白蛋白尿的老年糖尿病患者发生无症状心肌缺血较常见,通常在较低的运动负荷下就可发生心肌缺血,应对他们采取积极的冠心病预防措施。     

平板运动试验致ST段抬高的临床分析

目的探讨平板运动试验诱发ST段抬高对冠心病的诊断价值。方法分析12例无心肌梗死而运动诱发ST段抬高的运动心电图及冠脉造影检查结果。结果12例患者冠脉造影均显示有不同程度的血管狭窄（50%～100%）;ST段抬高导联与缺血相关血管有良好对应关系。结论平板运动试验诱发的ST段抬高是冠脉严重狭窄或痉挛所致严重心肌缺血损伤的表现。     

ST／HR斜率法在冠心病诊断中的应用

心电图运动试验是诊断冠心病最常用的方法,但以 ST 段压低的标准诊断冠心病则敏感性和特异性较低,晚近提出了 ST/HR 斜率指标以期提高其     

动态心电图在无症状性心肌缺血冠心病诊断中的价值

目的探讨动态心电图（DCG）对检测冠心病患者无症状性心肌缺血的临床价值。方法用DCG记录96例冠心病患者ST段下移阵次数、ST段下移持续时间、当时有无症状、发作昼夜时间规律及发作前后心率的变化。结果缺血性ST段下移336阵次,其中无症状发作246阵次,有症状发作90阵次;无症状性心肌缺血持续时间（5.4～12）min/次,有症状性心肌缺血持续时间（14～24.6）min/次,两者比较差异有统计学意义（P〈0.05）。结论 DCG是临床上诊断心肌缺血尤其是无症状性心肌缺血（SMI）的敏感性、特异性、准确性都较高,大大提高了SMI的检出率,为目前较理想的非创伤性检查方法。     

ST/HR斜率联合ST段标准诊断介入术后再狭窄的研究

目的通过探讨心电图运动试验测定ST／HR斜率联合常规ST段标准诊断冠心病介入术后再狭窄的敏感性和特异性。方法自2001年11月至2003年12月,对成功行冠脉介入治疗(PCI)的129例患者,在术后3-6个月进行随访,测量心电图运动试验ST／HR斜率及常规ST段阳性标准联合诊断再狭窄,通过冠状动脉造影确定有无再狭窄,评价其诊断再狭窄的价值。结果ST／HR斜率联合常规ST段应用诊断再狭窄的敏感性和特异性分别为42．5％、97．4％,特异性高于传统ST段标准(66．7％),P<0．05。结论ST／HR斜率联合常规ST段标准可作为诊断再狭窄的无创手段。     

无症状性心肌缺血的动态心电图诊断价值

目的使用动态心电图监控冠心病中无症状性心肌缺血的临床症状,通过记录探究无症状心肌缺血的发病率、发病规律、发病时间、发病情况,并通过动态心电图诊断无症状性心肌缺血及指导临床治疗来体现其应用价值。方法对116例冠心病患者采用12导联动态心电图记录系统进行24h监测。结果 116例冠心病患者有108例发生心肌缺血(病发率93.1%),检测出的心急缺血共发作562次,其中有482次是无症状性心肌缺血(病发率85.8%);ST段下移在早上6-12点之间最为频繁,在0-6点出现率最低;夜间心肌缺血阀的变异值出现上升,ST段下移持续时间长;心率加快,引发严重的心肌缺血。结论动态心电图对诊断无症状心肌缺血有较为理想的诊断效果,属于非创伤性的辅助检查方法。     

心电图监护导联与常规导联ST段压低的对比分析

<正> 目前,心电监测普遍开展,且多选用CM_5或CC_5导联,临床发现其无症状性ST段压低发生率和下降幅度均较常规导联明显增加。为此,我们对比分析了111例可疑冠心病患者静息及平板运动试验时监护导联与常规梦联ST段压低的情况,以期寻找两者间关系,探讨监护导联ST段压低的临床意义。对象和方法一、对象111例临床可疑冠心病,但常规导联心电图无缺血性ST-T异常,尚不能确诊者。其中男76例,女35例;年龄36～64岁。二、     

常规心电图ST段改变对右室梗死的诊断价值

右室梗死(RVMI)的心电图早期诊断主要依据右胸导联ST段改变,如V_4R ST段抬高幅度≥1 mm。本文通过对照观察下壁梗死合并右室梗死常规心电图改变与右胸导联ST抬高的关系,探讨ST↑Ⅲ/Ⅱ>1与STV_2↓/STaVF↑≤0.5对右室梗死的诊断价值。 1 资料与方法 1.1 58例患者均为发病10小时内就诊。临床症状、心电图改变和血清酶演变均符合急性下壁心肌梗死诊断,排除陈旧性心肌梗死或同时合并前壁、高侧壁心肌梗死及束支传导     

持续静滴硝苯地平治疗冠心病心绞痛的疗效观察

对40例持续性ST-T改变的冠心病心绞痛患给予硝苯地平5mg 生理盐水500ml，以10μg/min速度静滴3天，心绞痛次数由治疗前4.36±1.8次/d减至治疗后0.3±0.74次/d(P<0.01）；14例ST段完全恢复正常，12例ST段有不同程度的改善；48个导联T波完全恢复正常，20个导联T波明显变浅，且对血流动力无明显影响，此提示硝苯地平要有效地缓解心绞痛，减轻心肌缺血，对以及有一定的保护作用。     

酪氨酸激酶抑制剂STI571对慢性粒细胞性白血病K562细胞周期的作用及机制

目的:研究酪氨酸激酶抑制剂STI571对K562细胞周期的作用及机制.方法:以逆转录-聚合酶链反应和Western blot方法分别检测ST1571处理K562细胞12、24、48 h后p38、ERK、cyclin D2、cyclin E、p27 mRNA和蛋白的表达,并以流式细胞仪检测其不同时间点细胞周期的变化.结果:ST1571处理后K562细胞p38、ERK、cyclin D2、cyclin E mRNA和蛋白表达降低,p27 mRNA和蛋白表达增高.G<0/G1期细胞增多,s期细胞减少,与用药前比较差异均有统计学意义(P<0.05).结论:STI571可能通过丝裂原活化蛋白激酶途径影响细胞周期调控蛋白,最终抑制K562细胞的增殖.     

Carbapenemase-producing Enterobacteriaceae in a tertiary hospital in Madrid,Spain: high percentage of colistin resistance among VIM-1-producing Klebsiella pneumoniae ST11 isolates

Here we describe the carbapenemase genes, genetic relatedness and antimicrobial susceptibility data of 123 carbapenemase-producing Enterobacteriaceae (CPE) clinical isolates recovered from 2010 to 2012, comprising Klebsiella pneumoniae (n = 79), Klebsiella oxytoca (n = 13), Serratia marcescens (n = 14), Enterobacter cloacae (n = 12), Enterobacter asburiae (n = 4) and Enterobacter aerogenes (n = 1). VIM-1 was the most common carbapenemase (n = 101) followed by KPC-2 (n = 19), OXA-48 (n = 2) and IMP-22 (n = 1). Among the K. pneumoniae isolates, nine sequence types (STs) were identified but two clones were dominant: ST11 (54/79) containing mainly VIM-1-producing isolates; and ST101 (13/79) constituted by KPC-2-producing strains. Pulsed-field gel electrophoresis (PFGE) showed a higher genetic diversity among the remaining Enterobacteriaceae. Amikacin and fosfomycin were the most active agents with 82.9% and 80.5% susceptibility, respectively. Non-susceptibility to tigecycline was detected in 36.5% of strains. Overall, colistin resistance was 24.7% and was as high as 47% in Enterobacter spp. An increase in colistin resistance from 13.5% to 31.7% was observed among K. pneumoniae isolates during the study period. Resistance was focused on ST11 since 83.3% of colistin-resistant strains belonged to this clone. The high level of colistin resistance observed in this study is worrying with respect to the already limited therapeutic options for infections caused by multidrug-resistant Gram-negative bacteria.     

HPLC法测定盐酸米多君的含量及其有关物质

目的 采用HPL 测定盐酸米多君片的含量及其有关物质 ，以控制产品质量。方法 以ODS为固定相，流动相为甲醇-磷酸盐缓冲液(pH3.0)( 23∶77)，检测 波长为290nm，采用外标法。结果 盐酸米多君(ST1085-HC1)和杂质ST1059-HC1的线性范围分别为0.025～0.25mg·ml-1(r＝0.99999，n＝6)和4～40μg·ml-1(r＝ 0.99994，n＝6)，回收率分别为99.5%和101.7%。结论 本法结果准确， 简便且重现性好，能有效地控制质量。     

PREVENTIVE EFFECT OF A NEW CALCIUM ANTAGONIST, MONATEPIL, ON DRUG-INDUCED ISCHAEMIC ELECTROCARDIOGRAPHIC CHANGES IN RATS

1. The preventive effects of monatepil, a new calcium antagonist with α₁-adrenoceptor blocking activity, on ischaemic electrocardiographic changes in rat models of vasospastic angina were evaluated and compared with those of the existing calcium antagonists (diltiazem, verapamil, nicardipine and nifedipine). 2. In order to assess the contribution of the α₁-adrenoceptor blocking action of monatepil to its anti-vasospastic action, the anti-ST depression effect of prazosin, an α₁-adrenoceptor blocker, was also examined. 3. Monatepil given orally (3–30 mg/kg) inhibited vasopressin (0.2 IU/kg, i.v.)-induced ST depression which is considered to indicate ischaemic electrocardiographic changes in a vasospastic angina. This effect of monatepil was more potent and long-lasting than that of diltiazem, and was similar to that of verapamil and nicardipine. At a dose of 30 mg/kg, monatepil produced a significant inhibition, even at 7 h after administration. 4. Monatepil given intravenously (0.3 mg/kg) exerted a significant inhibitory effect on methacholine (16 μg/kg, intracoronary arterial administration; i.c.a.)-induced ST elevation which seems to be caused by coronary vasospasm. This effect was more potent or equipotent to those of the existing calcium antagonists. 5. These results indicate that monatepil produces the preventive effect on the drug-induced ischaemic electrocardiographic changes in rats and suggest that monatepil may have potential for the treatment of vasospastic angina.     

急性下壁心肌梗塞胸导联ST段改变对预后的判定

目的探讨急性下壁心梗时心电图心前导联ST段的压低、压低幅度及持续时间。寻找早期判定急性心肌梗塞重危患者的指标。方法84例下壁心肌梗塞分为有ST段压低组及无ST段压低组。根据ST段压低持续时间分为A组和B组。A组为ST段压低在1周内恢复 ;B组为ST段持续压低超过1周未恢复。对上述各组严重并发症的发生率及住院死亡率进行比较。结果严重并发症的发生率与住院死亡率有ST段压低组较无ST段压低组明显增高P<0.05 ;在有ST段压低组严重心律失常、心源性休克、急性左心衰及住院死亡率 ,B组明显高于A组P<0.01。有严重并发症者的ST压低幅度总和明显大于无严重并发症者 ,P<0.01。结论急性下壁心肌梗塞心前导联ST段压低、压低幅度越大 ,持续时间越长者 ,其病情重 ,并发症多 ,预后差     

Factors associated with smokeless tobacco cessation in an Appalachian population

Identifying factors associated with successful tobacco quit attempts may help in the development and targeting of effective cessation strategies. This paper aims to describe factors associated with smokeless tobacco (ST) cessation and compares the results to findings in the smoking cessation literature. Prospective data on 116 men aged 19 to 70 and participating in a ST cessation program were used to examine correlates of successful ST cessation at 1-year post-intervention. Controlling for age, level of education (p=0.002) and daily coffee consumption (p=0.005) had significant independent associations with successful cessation. No ST use variables were significant predictors of cessation success. In a multivariable logistic regression model three factors were significantly associated with cessation: education (p=0.010), coffee consumption (p=0.019), and age (p=0.029). Factors associated with successful ST cessation in this sample are consistent with predictors of smoking cessation reported in the literature. Based on its widespread use and the strength of its association with successful quitting, the role of caffeine consumption in ST cessation merits further study.     

3-偶氮甲基利福霉素抗结核作用的实验研究

3-偶氮甲基利福霉素又称FCE22250,在国内首先由四川抗菌素工业研究所研制成功,本文报道它的体内外抗结核菌活性及其在小鼠体内血药浓度的变化。 实验表明:(一)FCE22250对人型结核分枝杆菌H37Rv的抑菌作用与利福平、利福喷丁相近或略强。(二)FCE22250体内抗结核菌活性显著强于利福平,略优于利福喷丁。(三)FCE22250呈显著长效抗结核活性,给小鼠一次灌胃12mg/kg其抗结核活性的有效浓度可维持10～12天,而利福平在同样条件下最长维持1天,利福喷丁可维持7天。(四)FCE22250的小鼠血浆半衰期达37.7小时,利福平为4.0小时,利福喷丁为31小时。FCE22250给小鼠灌胃12mg/kg,9天后血浆中药物浓度的实测值为0.19微克/毫升(仍可达到其体外最小抑菌浓度)。FCE22250是迄今血浆半衰期最长的抗结核菌药物。     

急性心肌梗死“墓碑样”ST段改变的临床意义

回顾性分析了1984～1995年急性心肌梗死146例,其中包括“幕碑样”ST段改变者19例(13.01％),1周内病死率63.15％。ST段“墓碑样”改变者预后差的临床因素是:梗死部位89.47％为前壁范围;nST、∑ST、nQ、∑Q均高于对照组,说明心肌损伤、坏死的范围和程度都较重,临床严重合并症多。“墓碑样”ST段改变者QTcd为(79.33±28.58)ms,较对照组明显增加。猝死者占死亡人数的66.67％。认为QTcd延长是ST段“墓碑样”改变组临床预后差的独立因素。     

心电图 ST段水平延长对冠心病诊断价值的探讨

目的：探讨心电图ST段水平延长对冠心病诊断的价值。方法对66例胸痛患者行心电图及冠脉造影检查,对ST段正常组和ST段延长组与冠心病的关系进行分析。结果当ST段水平延长≥0.12 s,两组间冠状动脉造影阳性率差异有统计学意义（ P＜0.01）。结论心电图ST段水平延长与冠心病有相关性。     

急性前壁心肌梗塞ST段呈墓碑形抬高的临床分析

目的 探讨前壁急性心肌梗塞(AMI)ST段呈墓碑形抬高的临床意义。方法68例前壁AMI分为ST段呈墓碑形抬高组(A组,19例)和ST段呈常态形抬高组(B组,49例),比较两组患者的心电图(ECG)特点及临床资料。结果 (1) A组出现对应导联ST段下移13例(68.42%),B组14例(28.57%)(P<0.05);(2)A组QT间期离散度(QTd)(69.98±18.26ms)明显高于B组(60.11±16.94ms)(P<0.01);(3)室性心律失常A组11例(57.89%),B组9例(18.36%)(P<0.05);(4) A组血清磷酸肌酸激酶(CK)及其同工酶(CK-MB)峰值为(2317.1±657.4)u/L和(264.4±127.9)u/L,明显高于B组的(1892.2±548.9)u/L和(137.6±88.5)u/L(分别为P<0.005和P<0.01);(5) 冠脉造影A组17例(89.47%)呈多支病变,B组30例(61.22%)(P<0.01)。结论AMI后 ST段呈墓碑形抬高患者梗死面积大,室性心律失常发生率高,冠状动脉病变严重。